How to Recognize and Treat Diaper Rash

Every mom has experienced it — baby seems fussy, fidgety, and ill-tempered, but the reason behind it is a mystery. Then, a routine diaper check reveals the telltale bright red and patchy start of that all-too-common malady, diaper rash.

Learning to treat and prevent this routine skin condition is fairly simple, but parents who don’t know the ins-and-outs of diaper rashes may be left wondering what went wrong, how to prevent future occurrences, and if diaper rash merits a visit to the pediatrician for medical advice.

We’ve covered all that and more, so read on.

What is Diaper Rash?

Diaper rash refers to a type of skin inflammation, or dermatitis which is found in the diaper area, including the buttocks, genitals, and surrounding skin. It appears as visibly irritated and red patches of skin, which may be small or large. Moisture from missed diaper changes, allergic reactions, infections and chafing are all possible causes of the reaction. Although it can be quite uncomfortable for babies, with an appearance to match, the condition can typically be resolved completely at home without involving a pediatrician.

What are the Main Symptoms of Diaper Rash?

As diaper rash is a skin condition rather than a systemic illness, the presentation of symptoms comes down to the appearance of the rash itself and your child’s reaction to its presence. Basically, there are two ways to discover diaper rash:

  • Relatively minor cases may be spotted by parents during a diaper change before the rash is severe enough for baby to react; diaper rash has a bright red, tender, patchy appearance and may be seen on the diaper area of baby’s skin, including buttocks, genitals, thighs, and surrounding skin.

    What are the Main Symptoms of Diaper Rash?

  • If baby seems fussy, uncomfortable, and annoyed for no particular reason, or reacts with fussing or tears during diaper changes, look carefully to see if there’s any diaper rash present.

Can Diaper Rash be Serious?

Typically, diaper rash is not a serious condition and will resolve through home treatment within a few days. However, if baby’s diaper rash doesn’t seem to be improving, you may need to call the doctor for a prescription cream to help the rash resolve.

A few other situations in which diaper rash merits a trip to the doctor:

  • The diaper rash is unusually severe or doesn’t look like standard diaper rash
  • The diaper rash is getting worse and not better in response to your treatment attempts
  • Their diaper rash is bleeding, oozing, or itching
  • They are unable to urinate or defecate without pain due to their diaper rash
  • They have a fever

Editor’s Tip: In clinical practice, I commonly see infants with diaper rashes that are not improving. Often, more than one over-the-counter diaper rash cream has been tried, but the rash persists. Such rashes may be caused by fungal overgrowth or, less commonly, by bacteria, and require prescription treatment.1Blume‐Peytavi, U., & Kanti, V. (2018). Prevention and treatment of diaper dermatitis.Pediatric dermatology, 35, s19-s23.

How do I Treat Diaper Rash?

Proper treatment of diaper rash typically helps the uncomfortable condition to clear up within a few days. Here are a few best practices to follow when treating your little one’s rash:2Diaper Rash

  • Approved creams only: Use creams designed for diaper rash, such as those that are zinc oxide or petroleum jelly-based, unless your pediatrician prescribes otherwise. Using strong steroidal creams or using steroids in the long term can be bad for baby. If your doctor does prescribe a cream that contains a steroid, it is typically intended for only one to two weeks of use. Diaper rashes that are caused by infections are treated with an appropriate antifungal cream or antibiotic.
  • Change them ASAP: Keep baby’s diaper area dry and clean as often as possible. This means changing baby as soon as you’re aware of a soiled diaper, and cleaning and drying baby’s bum during the change. Some parents prefer to give baby a full “wash” with each diaper change by keeping a water spray bottle near the changing station. Finish the diaper change with a thorough pat-dry, and create a moisture barrier using an approved petroleum jelly or zinc oxide based cream. For infants who seem to get frequent diaper rashes, I recommend using a small hand-held fan to make sure the area is very dry before putting on a clean diaper.
  • Let their skin breathe: Don’t be afraid to let baby go without a diaper for a while. Air-drying is one of the best things for baby’s skin, so lay them on an old towel and let their skin breathe when possible.
  • A bath every day: Daily baths in warm water with mild, fragrance-free soap helps to whisk bacteria and yeast away from baby’s sensitive skin, helping to relieve the rash and prevent its spread. Make sure baby is fully dry and cream is used before they go back into a diaper.


What are the Best Ways to Prevent Diaper Rash?

Adopting some best practices in your baby care can go a long way in preventing future outbreaks of diaper rash. Once you master these simple rules, they’ll be like second nature — and baby’s sensitive skin will thank you.

  • Stay clean and dry as often as possible: Clean, dry skin is best for avoiding rashes and irritation, which means that parents must be focused on changing a wet or soiled diaper as soon as they notice it. Yes, we know, this can get quite costly when using a disposable diaper for a frequent producer or a sick child. Parents who find themselves going through too many packs might want to use cloth diapers, some of which have adjustable sizes to prevent chafing as baby grows.
  • A full clean during their change: Whether you dunk baby in the tub or just use a handy spray bottle of room temperature or warm water, giving baby’s bottom a full clean while they’re being changed means there’s less bacteria lingering on their skin to cause irritation and infection. If you use cloth diapers, that water bottle can pull double duty when preparing their soiled nappies for the diaper bucket.
  • Let them have naked time: Even when baby isn’t recovering from an active rash in their diaper area, being uncovered so skin can breathe is normal and healthy. After drying off post bath time, lay out a big old towel and let baby play for a while without a diaper on so their delicate skin can have some time to breathe.
  • Regular cream use if they’re prone: If your little one is especially prone to irritated skin and diaper rash, consider using creams on baby’s bottom on a regular basis. Barrier ointments containing petroleum jelly or zinc oxide are best, and remember to avoid steroid creams unless a doctor prescribes them. The regular use of topical corticosteroids is correlated with adverse health outcomes in babies and children in some situations3, so these creams should only be used regularly under a doctor’s care.3Lipsher, D., Kragballe, K., Fogh, K., & Saurat, J. H. (2003). Other topical medicatilons. In Dermatology, Jl Bologna, Jl Jorizzo, Rp Rapini, 2055-2270.
  • Choose the right products for bath time and laundry: Not every product marketed as being “for babies” is actually great for your baby’s skin, especially if they’re prone to irritated skin. Skip over soaps, shampoos, lotions, and oils that use synthetic fragrances, dyes, and cleaning agents. They’re common culprits in diaper rash, and can irritate baby’s skin all over. Scented laundry detergents can do the same, so opt for fragrance free detergent, especially when washing clothes and cloth diapers.
  • Pat dry, don’t rub: If they’re prone to diaper rashes, pat baby’s bottom thoroughly to dry it rather than rubbing. Rubbing vigorously can damage the surface of the skin, triggering the opportunity for a rash to develop.
  • Avoid too-tight diapers: When the waist or thigh bands of a diaper are too tight, it’s impossible for airflow to reach the skin in the diaper area. This creates a closed pocket of heat and moisture, which is the perfect environment for a bacterial or yeast infection to form, creating diaper rash, especially during warm weather months. If you’re using disposable diapers, consider moving up in size if you see any indications of tightness, such as marks around baby’s waist or thighs where the diaper sits. Another option is the use of cloth diapers, some of which use a snap system to allow diapers to be sized up as needed when baby grows.
  • Always wash your hands thoroughly: We probably don’t need to tell you this, but it’s important to wash your hands thoroughly with soap and water after changing your baby’s wet or soiled diaper.4Safe & Healthy Diapering in the Home

    Not only does this rid your hands of bacteria present in human waste, but it washes away rash-triggering bacteria and yeast present on the skin which could transmit a rash to you or another child in your home.


What Types of Products are Best for the Treatment and Prevention of Diaper Rash?

If you’re concerned that the types of products you’ve been using are triggering baby’s diaper rash, you may be wondering exactly what you should be stocked up on to ensure baby stays comfortable and healthy. Here are a few products that can be switched in order to treat or prevent diaper rash more effectively.

  • Bath products: Choose unscented, dye-free, and naturally derived soaps, shampoos, lotions, and oils when bathing your baby. This avoids triggering sensitive skin and causing a rash. Examples: Aveeno Baby Body Wash & Shampoo, Cetaphil Baby Wash and Shampoo, Eucerin Baby, CeraVe Baby
  • Laundry detergent: Look for a detergent that’s mild and skips over fragrances and dyes. There are options available which are branded as being “just for baby”, but you may consider switching the whole family over to a fragrance-free option to save money on detergents. Examples: Babyganix Fragrance Free Laundry Detergent, Dreft Pure Gentleness, All Free Clear, Tide Free & Gentle
  • Barrier ointments: Choose creams and ointments that are designed specifically for the prevention and treatment of diaper rash. It’s best to look for options based on petroleum jelly or zinc oxide, avoiding steroid creams unless they’ve been recommended by the pediatrician. Examples: A&D Ointment, Desitin, Boudreaux’s Butt Paste, Aquaphor Baby Healing Ointment

What Should I Avoid When Treating Diaper Rash?

When treating and preventing diaper rash, making the right product and lifestyle choices is essential. As a final review, here’s what you should be avoiding:

  • Scented soaps, shampoos, lotions, oils, and laundry detergents, or those which use harsh chemicals or dyes
  • Steroid creams, including over the counter hydrocortisone cream, unless they’ve been prescribed or recommended by your child’s pediatrician
  • Diapers that are too small or too tight, which prevent skin from breathing properly
  • Introducing new foods, which can trigger digestive upset or skin sensitivity
  • Scented baby wipes, which can trigger a reaction in sensitive-skinned children

The Bottom Line

The good news on diaper rashes is that though they are uncomfortable, treating and preventing them is fairly easy once you know what to do. Avoiding triggers like time spent in wet or tight diapers and scented, chemical-laden products is a great first step, and giving their skin time to breathe is a big help as well. You probably won’t need to call the doctor for medical advice if best practices are followed, but if something seems amiss, don’t be afraid to reach out. Diaper rashes are just one more milestone to navigate on the rocky road of parenting, but with a little thought and intent, their bottom line will be consistently fine in no time.

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